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General NPI Number Information
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NPI Number | 1215150396
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Entity Type | Organization
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Legal Business Name | LAKEWOOD RANCH URGENT CARE P A
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 3924 9TH AVE
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City | BRADENTON
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State | FL
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Zip | 34205
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Country | US
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Telephone | 941-447-5854
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Fax |
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Provider Business Mailing Address
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Address Line | 7322 MANATEE AVE W # 108
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City | BRADENTON
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State | FL
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Zip | 34209-3441
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Country | US
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Telephone | 941-447-5854
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC FOLKENS
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Credential | M.D.
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Telephone | 941-524-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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